Saturday, 29 August 2015

Malta Today: 1980s ban on gay blood next taboo in line of fire

The issue was recently raised by the government’s LBTIQ consultative committee in an action plan that proposes to address the ban, originally introduced because men having sex with men had a higher risk of HIV infection than heterosexuals.

29 August 2015, 7:30am by Martina Borg

The lifetime ban on sexually active gay men remains a controversial aspect of medical norms in a society that is otherwise now geared towards more equal rights for gay people, and scuttling the prejudice they face in daily life.

The issue was recently raised by the government’s LBTIQ consultative committee in an action plan that proposes to address the ban, originally introduced because men having sex with men had a higher risk of HIV infection than heterosexuals.

“While the prevalence of HIV is still higher among men who have sex with men, the improvement in testing procedures available nowadays, make such life-time bans unjustifiable,” Gabi Calleja, coordinator of the Malta Gay Rights Movement and chair of the LGBTIQ council.

The higher incidence of HIV in men who have sex with men is attested in figures supplied by the health ministry’s department of disease prevention. In 2014, 27 out of 39 cases of HIV in males fell into the category of men who have sex with men, and 2015 has seen some 30 HIV cases out of 33 pertaining to the same category (until 23 July).

The lifelong ban, in place since the mid-1980s in a number of European countries including Germany, France, Holland and Belgium, dates back to a time when not much was yet understood about HIV and, by extension, when tests for the virus hadn’t been fully developed yet.

But modern technologies have developed that can detect the presence of the virus even when it is still in its incubation period. As the health ministry confirmed in no uncertain terms, all blood donations at the National Blood Transfusion Unit are effectively tested for HIV, Hepatitis B and C, as well as syphilis.

“Potential donors also have their haemoglobin assessed and undertake a medical examination before donating their blood,” a spokesperson said, explaining that some 350 units of blood re checked for the aforementioned disease markers on a weekly basis.

While the LGBTIQ council would welcome the removal of the ban, it seems more likely that the blood donation ban would be tweaked by introducing a time window from a man’s last sexual contact would be established.

“This would still however discriminate against those men in stable committed relationships,” Gabi Calleja said. “While agreeing and accepting that the safety and integrity of blood supplies remains paramount, MGRM feels that the increasing evidence in favour of ending the lifetime ban on this particular group is overwhelming.

“The evidence and practice in a number of countries with previous lifetime bans has led some countries to modify and refine their eligibility criteria to take into account current evidence and best practice,” she said, adding that those countries making progress on LGBTIQ issues had ultimately realised that the ban was unnecessary, maintained not for scientific reasons but prejudice.

Parliamentary secretary for health Chris Fearne has now appointed a technical committee to make recommendations on whether gay men should be allowed to donate blood. “We are studying the proposed reversal of the lifelong ban on blood donations by gay men from both a scientific standpoint as well as from an angle of equality legislation,” Fearne said.

The assessment will take stock of the situation, together with international studies in this field and changes that had taken place following the policies of other countries.

“The change from previous blanket and permanent deferrals in other countries has largely been a result of the recognition of advances in the testing and processing of donated blood, changes in the epidemiology of sexually transmitted infections (STIs) and improved scientific knowledge, which have prompted a review of donor deferral on the basis of sexual behaviour,” Calleja said.

She quoted a review of evidence completed by SaBTO (the UK Advisory Committee on the Safety of Blood, Tissues and Organs) which found that improvements in processes and automation significantly reduced the chance of errors in blood testing.

“One conclusion the report makes, is that the modelled risk of HIV-infectious donation being released into the blood supply had been placed at 1 per 4.4 million donations, and that the introduction of a 12-month deferral period would not significantly affect this figure,” Calleja said.

Appealing to the sense of universal acceptance, Calleja explained that the ban was discordant with current social developments. “The radical changes in both the legal and social consideration of same sex relationships show that society has become less accepting of perceived unfairness or discrimination, and given that blood donation is positioned as an important act of social responsibility and solidarity, the exclusion of men who have sex with men suggests something contradictory.”

She added that the ban passes a marginalising message at odds with the emphasis on the LGBTIQ community being a fully accepted part of society. As the SaBTO report points out, gay men are also less willing to accept being ‘lumped together’ as a single risk category, irrespective of their own sexual behaviour and risk-taking.

“We look forward to the National Blood Transfusion service adopting such an evidence-based approach, and changing the criteria for donation by men who have sex with men,” Calleja said.

Other groups facing lifetime ban on blood donation

• Sufferers of cancer or a malignant disease

• Those who had potential exposure to Creutzfeldt-Jacob (Mad Cow) disease

• Patients suffering from insulin-dependent Diabetes Mellitus

• Those who have a history of intravenous drug abuse

• Those with heart and blood vessel disease

• People who have infectious conditions like carriers of the HIV virus, leishmaniasis and Q-fever among others

• Persons whose sexual behaviour puts them at high risk of acquiring severe infectious diseases that can be transmitted by blood

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Note: The Civil Unions Bill [20/2014] has successfully passed through the Maltese Parliament with 37 votes in favour, 30 absentions and 0 votes against on the 14th April 2014. It gives the same rights and obbligations to same-sex couples as those who are registered in a civil marriage (mutatis mutandis).